[poppy07]

We used the rapid infuser on a sick s/p c-section pt in DIC while simultaneously infusing blood in other lines, including one y-sited iv with blood in both lines. At some point, pt skin became reddened...maybe it was a reaction?

All the docs were there and even helping with the multiple simultaneous blood infusions... Is this practice okay?

[poppy07]

A Los Angeles transfusion service physician reports that in his opinion there is no restriction to giving a patient multiple transfusions simultaneously, so long as one observes some basic rules. First, one must never mix ABO-incompatible products in the same bag or line. If one were to do so, and if the mixture contained red cells, agglutination might occur due to ABO antibodies. For example, group O platelets should never be mixed in the same line at the same time as group A red cells. Second, if multiple products are administered simultaneously, they should be given through different lines. As a practical concern, if multiple products are given simultaneously, it might be difficult to know which unit is responsible for a reaction, should a reaction occur.

http://www.cbbsweb.org/enf/2002/multprodsimult.html

[2bestrong]

Well.... It's a 'common' practice when using the Level 1.
There is nothing common about rapidly infusing the amount of fluid/blood you infuse when someone is septic and hypotensive.

[poppy07]

not sure what you are saying here....

[2bestrong]

Sorry, I was being sarcastic.. that there is nothing 'common' about rapdily infusing multiple amounts of fluids/blood into a patient when they are decompensating.
So yes, it is common for us to infuses mulitple bags of fluid as well as mulitple blood products. But of course we follow all the P & P when administering each individual product.

[nursejill155]

When you are using the rapid infuser, you might as well through the policies out the window. If you have to use it in the first place, your patient is dying or will die and that is what a level 1 does, infuse a TON of blood in a short period of time (usually minutes). Being honest a blood rxn would be the last thing on my mind at that time, in a situation like that, you either do what you have to do or might as well kiss the pt goodbye!

[Christie RN2006]

It isn't necessarily recommended to be giving more than one blood product at a time, but if it is life and death, then by all means give as much as you can as fast as you can. I had a trauma patient one time that had a central line and 2 peripheral lines and we were pushing blood, FFP, NS, and Albumin as fast as we could. The pt was also maxed on Neo and dopamine. We pressure bagged 2 units of blood at a time, but everything was through separate lines. You should never mix blood with anything other than NS.